The effect of autologous concentrated bone-marrow grafting on the healing of femoral shaft non-unions after locked intramedullary nailing

Guimarães, João Antônio Matheus; Duarte, Maria Eugênia Leite; Fernandes, Marco Bernardo Cury; Vianna, Verônica F; Rocha, Tito Henrique; Bonfim, Danielle Cabral; Casado, Priscila Ladeira; Guimarães, Isabel Cristina Chulvis do Val; Velarde, Luís Guillermo Coca; Dutra, Hélio S.; Giannoudis, Peter V.

doi:10.1016/s0020-1383(14)70013-0

Cited by 55 publications

(29 citation statements)

References 53 publications

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“…Reaming graft has been demonstrated to result in improvement of local biology and stimulation of bone healing at the nonunion site [21]. In addition, utilization of reaming debris instead of stem cells or autologous bone marrow grafting does not require an additional surgical procedure to harvest biological material [29]. Reaming debris contains viable osteoblast-like cells and growth factors, and therefore may act as a natural osteoinductive scaffold.…”

Section: Discussionmentioning

confidence: 99%

Reamed intramedullary exchange nailing in the operative treatment of aseptic tibial shaft nonunion

Hierholzer

Friederichs

Glowalla

et al. 2016

International Orthopaedics (SICOT)

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Purpose The aim of this study was to evaluate a standardized treatment protocol regarding the rate of secondary bone union, complications, and functional outcome. Methods This study was started as a prospective study in a single Level I Trauma Centre between 2003 and 2012. The study group consisted of 188 patients with the diagnosis of an aseptic tibial shaft nonunion. Exchange nailing was performed following a standardized surgical protocol. Long-term followup was analyzed for rate of bone healing and functional outcome. Results Osseous healing was achieved in 182 out of 188 patients (97 %). In 165 out of 188 patients (88 %), bone healing was observed timely and uneventfully after a single exchange nailing procedure. An open approach was necessary in 32 patients (17 %). Twenty-three patients (12 %) required additional therapy such as extracorporeal shock wave therapy. Post-operative complications were observed in seven patients (4 %). Almost all patients demonstrated osseous healing within 12 months, with the majority of osseous healing occurring within six months. A relevant shortening of the fractured tibia was observed in 20 out of 188 patients (11 %). After a median follow-up of 23 months (range 12-45 months), outcome was evaluated using the assessment system of Friedman/Wyman. In summary, 154 out of 188 patients (82 %) had a good functional long-term result. Discussion Reamed intramedullary exchange nailing including correction of axis alignment is a safe and effective treatment of aseptic tibial shaft nonunion with a high rate of bone healing and a good radiological and functional long-term outcome.

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Section: Discussionmentioning

confidence: 99%

Reamed intramedullary exchange nailing in the operative treatment of aseptic tibial shaft nonunion

Hierholzer

Friederichs

Glowalla

et al. 2016

International Orthopaedics (SICOT)

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“…Bone marrow provides a cellular environment for bone formation; thus, injection of BMAC can provide an osteogenic stimulus and promote bone healing [Guimaraes et al, 2014]. To the best of our knowledge, this is the first comparative study that reports the effectiveness of atelocollagen alone and an atelocollagen and BMAC mixture in bone defect healing.…”

Section: Discussionmentioning

confidence: 94%

“…Recently, many clinical trials have been performed on the treatment of nonunion or delayed union with bone marrow or bone marrow cultures, including osteoprogenitor cells that differentiate into osteoblasts [Hernigou et al, 2005;Kim et al, 2009;Gomez-Barrena et al, 2011;Braly et al, 2013;Guimaraes et al, 2014;Le Nail et al, 2014;Sugaya et al, 2014;Hernigou et al, 2016]. As nonunion or delayed union is caused by multiple complicated factors, the strategy of reducing their incidence or preventing their occurrence merely by addressing the issues related to physicians' techniques will only be partially successful [Herscovici et al, 2000].…”

Section: Discussionmentioning

confidence: 99%

Enhancement of Healing of Long Tubular Bone Defects in Rabbits Using a Mixture of Atelocollagen Gel and Bone Marrow Aspirate Concentrate

Park

Shetty

Kim

et al. 2017

Cells Tissues Organs

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We evaluated the bone-forming potential of a mixture of atelocollagen and bone marrow aspirate concentrate which was transplanted into bone defects. Radial shaft defects of about 10 mm in size were created in 30 New Zealand white rabbits. Ten rabbits in the control group were not treated further, 10 rabbits in the first experimental group (E1) received an atelocollagen injection, and 10 rabbits in the second experimental group (E2) received an injection of a mixture of atelocollagen and bone marrow aspirate concentrate. The groups were compared radiologically at 8 weeks. Osteogenesis in group E2 progressed more rapidly than that in the other groups, and osteogenesis in group E1 progressed faster than that in the control group. Thus, the administration of a mixture of atelocollagen and bone marrow aspirate concentrate in bone defects was found to enhance bone defect healing.

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“…According to the diamond concept [12,[124][125][126][127], the biological elements of these therapies should involve MSCs and growth mediators including those promoting the new vasculature formation. Whether MSCs are delivered within concentrated or not-concentrated mononuclear bone marrow cells [128,129] or as culture-expanded pure population and loaded on matrices [130] or injected subcutaneously [131], their therapeutic use still needs further optimisation. The inflammation status could affect considerably the effectiveness of the regenerative treatments at least in part via their effect on MSCs [132].…”

Section: Therapeutic Implicationsmentioning

confidence: 99%

The roles of immune cells in bone healing; what we know, do not know and future perspectives

El-Jawhari

Jones

Giannoudis

2016

Injury

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The effect of autologous concentrated bone-marrow grafting on the healing of femoral shaft non-unions after locked intramedullary nailing

Cited by 55 publications

References 53 publications

Reamed intramedullary exchange nailing in the operative treatment of aseptic tibial shaft nonunion

Reamed intramedullary exchange nailing in the operative treatment of aseptic tibial shaft nonunion

Enhancement of Healing of Long Tubular Bone Defects in Rabbits Using a Mixture of Atelocollagen Gel and Bone Marrow Aspirate Concentrate

The roles of immune cells in bone healing; what we know, do not know and future perspectives

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